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SEAN TYLER O'SULLIVAN DO
NPI 1285073205
Family Medicine in Scarborough, ME

Active since June 24, 2013PECOS EnrolledAccepts Medicare Assignment
153 US ROUTE 1, SCARBOROUGH, ME 04074(207) 799-8596 Get Directions Write a Review

NPPES record last updated: September 28, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 28, 2020, Jan 10, 2018 (2 updates tracked since 2018).

About Sean Tyler O'sullivan Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SEAN TYLER O'SULLIVAN DO (NPI 1285073205) is an individual family medicine provider in Scarborough, Maine, licensed in Maine (DO2641) and active in the NPI registry since June 2013. He is enrolled in Medicare PECOS, is affiliated with Northern Light Health, and is a graduate of University Of New England, College Of Osteo Medicine (2013).

NPPES Registry Identity

NPI1285073205
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameSEAN TYLER O'SULLIVANCredential: DO
Location Address153 US ROUTE 1Scarborough, ME 04074-9052
Mailing AddressPo Box 9746Portland, ME 04104-5040 · (207) 791-3888
Phone(207) 799-8596
Sole ProprietorNo
Medical School CMSUniversity Of New England, College Of Osteo MedicineGraduated 2013
Enumeration DateJune 24, 2013
Last NPPES UpdateSeptember 28, 20202 updates tracked since enumeration
NPPES CertifiedSeptember 28, 2020
✔ NPI 1285073205 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ME · DO2641
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
153 US ROUTE 1, Scarborough, ME 04074
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Sean Tyler O'sullivan Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1153544374
PECOS Enrollment IDI20170721001966
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Sean O'sullivan reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Maine Medical Partners
2.1 mi
Family Medicine
300 PROFESSIONAL DR
Scarborough, ME 04074
  • Reassigned Medicare billing, Maine enrollment
  • 206 clinicians in this Medicare group
NPI 1467477349 (207) 883-3491
Mainehealth
7.6 mi
Family Medicine
272 CONGRESS ST
Portland, ME 04101
  • Reassigned Medicare billing, Maine enrollment
  • 98 clinicians in this Medicare group
NPI 1639194509 (207) 874-2466
Martin's Point Health Care, Inc.
9.2 mi
Family Medicine
331 VERANDA ST
Portland, ME 04104
  • Reassigned Medicare billing, Maine enrollment
  • 153 clinicians in this Medicare group
NPI 1366474611 (207) 791-3888
Central Maine Medical Center
36 mi
General Acute Care Hospital
300 MAIN ST
Lewiston, ME 04240
  • Reassigned Medicare billing, Maine enrollment
  • 920 clinicians in this Medicare group
NPI 1689653487 (207) 795-5646

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
126 services72 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
121 services73 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
100 services61 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
75 services64 patients
Blood test, lipids (cholesterol and triglycerides) 80061
A lipid panel is a blood test that measures fats and fatty substances, such as cholesterol and triglycerides. These substances are used by your body as a source of energy. High levels can lead to health issues, including heart disease.
57 services52 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
55 services55 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Northern Light Health

Acute Care Hospitals · Portland, ME
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number200008
Location144 State StreetPortland, ME 04101 · Cumberland County
Emergency services Birthing friendly

Maine Medical Center

Acute Care Hospitals · Portland, ME
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200009
Location22 Bramhall StPortland, ME 04102 · Cumberland County
Emergency services Birthing friendly

Central Maine Medical Center

Acute Care Hospitals · Lewiston, ME
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200024
Location300 Main StreetLewiston, ME 04240 · Androscoggin County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04074 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
83%275 patients4/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
78%594 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
70%94 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%3,742 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
61%961 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
99%570 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
77%1,659 patients4/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
98%1,659 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
48%1,659 patients3/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
55%1,659 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. TRISTAN DANIELLE TOBIAS PA-C
Physician Assistant
153 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 799-8596
DEIRDRE G. HOGAN LCSW
Social Worker (Clinical)
153 US ROUTE 1, SUITE 26, BOX 10
SCARBOROUGH, ME 04074
Cumberland County (207) 329-9621
SARA M HOFFMAN PA-C
Physician Assistant
153 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 799-8596
KATHRYN MICHAUD
Nurse Practitioner
153 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 799-8596
MS. CHRISTY L. MADORE NP-C
Nurse Practitioner (Family)
153 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 799-8596
ANGELEA NANNICELLI
Internal Medicine (Geriatric Medicine)
153 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 799-8596
SARA FREEDMAN MD
Family Medicine
153 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 799-8596
ERIK N STEELE DO
Family Medicine
153 US ROUTE 1
SCARBOROUGH, ME 04074
Cumberland County (207) 799-8596

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sean O'sullivan's NPI number?

The NPI number for Sean O'sullivan is 1285073205. It was assigned to this individual provider in the NPPES registry on June 24, 2013.

Where is Sean O'sullivan located?

Sean O'sullivan practices at 153 Us Route 1, Scarborough, ME 04074. The listed phone number is (207) 799-8596.

What is Sean O'sullivan's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Sean O'sullivan enrolled in Medicare?

Yes. Sean O'sullivan is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Sean O'sullivan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sean O'sullivan reassigns Medicare benefits to 4 organizations: Maine Medical Partners (Scarborough, ME), Mainehealth (Portland, ME), Martin's Point Health Care, Inc. (Portland, ME) and Central Maine Medical Center (Lewiston, ME). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sean O'sullivan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sean O'sullivan accept?

Health plans from Anthem Blue Cross and Blue Shield list Sean O'sullivan as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sean O'sullivan affiliated with any hospitals?

According to CMS data, Sean O'sullivan is affiliated with Northern Light Health, Maine Medical Center and Central Maine Medical Center.

When was this NPI record last updated?

The NPPES record for Sean O'sullivan was last updated on September 28, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.